Every year, tens of thousands of adults die and hundreds of thousands more are hospitalized due to diseases that could have been prevented by vaccination. The cost of this health burden to society, according to the Centers for Disease Control and Prevention (CDC), is roughly $10 billion per year. This failure stands in stark contrast to the success of childhood immunization. By integrating vaccinations into regular early-childhood health care visits—and by supporting them through public programs, for those who cannot afford to pay—many vaccine-preventable diseases are now nearly nonexistent among children aged <5 years in this country. Many of the lessons learned from developing a highly effective pediatric immunization program can be applied to the problem of underimmunization in adults (see the editorial commentary by Hinman and Orenstein 1  in this issue of the journal).

The nation has before it a major opportunity to improve immunization for adults. Newly licensed adult vaccines can prevent shingles (the zoster vaccine) and cervical cancer (the human papillomavirus vaccine). Other vaccines already recommended for many adults can prevent liver cancer (the hepatitis B vaccine) and complications of infections caused by influenza virus and pneumococci. Yet our track record in assuring that adults receive the vaccines recommended for them is poor. Although >90% of young children have received the individual vaccines recommended for them, coverage for adult vaccines can range from 26% to 65%, depending on the vaccine and the target population. For example, <60% of persons aged 50 years have received a dose of tetanus toxoid in the past 10 years 2  and <50% of persons aged 50–64 years at high risk of influenza receive the annual influenza vaccine 3 Coverage rates are even lower for the pneumococcal vaccine in high-risk groups 4 Racial and ethnic disparities compound the problem. Strengthening adult immunization coverage will require significant improvements in the health care system's ability and willingness to provide and deliver vaccines to adults. Policymakers, the public, providers, insurers, employers, and employees need to become more aware of the value of adult immunization. Providers often lack the technical expertise and resources to acquire certain vaccines and to keep them on hand. The infrastructure to deliver vaccines to underinsured and uninsured adults must be significantly bolstered. Vaccine payment in both private and public health sectors must be sufficient to cover costs and to serve as an incentive to make adult immunization a prominent part of the practices of physicians who care for adults. Health care quality measures, surveillance, and research are additional areas that are in need of improvement.

Most vaccines in use today have been recommended for young children or adults. Recently, several new vaccines targeted for adolescents have been licensed and recommended, including vaccines against meningococcal meningitis and cervical cancer and boosters against pertussis ("whooping cough"). Delivery, payment, monitoring, and support systems to vaccinate adolescents also need to be bolstered.

The Infectious Diseases Society of America (IDSA) offers the following principles as a blueprint for action and urges all health care providers, health officials, and policymakers to participate in the solutions. These principles may be further modified as new developments emerge. Improvements in the national capacity to immunize adults and adolescents can help to prevent disease, save lives, and ensure an effective system for the delivery of vaccines now in development. Importantly, this goal should be pursued in a manner that enhances rather than compromises pediatric immunization programs.

Spice is so rife in Britain’s jails that prisoners are now twice as likely to be addicted to the drug when they leave than before they enter, a leading expert has warned.

Dr George Ryan, of Public Health England, said spiralling use of the drug – a potent form of synthetic cannabis - was behind an explosion of violence in prisons, causing ‘deaths, bullying and violence’.

Dr Ryan, a Government advisor, warned that it was relatively easy for prisoners to smuggle in spice as it was a liquid which could be sprayed onto regular tobacco – which most prisons allow. It can even be sprayed onto a piece of paper ‘the size of a thumbnail’, to be smoked later.

He revealed that urine tests carried out in 10 prisons in north west England had showed around 8 per cent of prisoners tested positive for spice on arrival but 16 per cent were positive on release.

By contrast, levels of other drugs like cannabis, cocaine and heroin all dropped dramatically during prison sentences. Just one in 100 prisoners tested positive for cocaine on release compared to one in four on arrival.

Speaking at PHE’s conference at Warwick University, Dr Ryan said: ‘Perhaps the most alarming statistic of all is that prisoners are twice as likely to use spice when they leave prisons as when they arrive.

‘So, effectively, use of spice doubles when people are incarcerated.  ‘It’s a very potent drug so people get a lot more bangs for their buck. It remains a very affordable drug in prison for some people. Higher potency forms increase the risk of people becoming dependent.’

Spice is not one single drug but the name for a group of similar chemicals known as synthetic cannabinoids designed to mimic the effects of cannabis. The drugs were sold as legal highs but were banned last year.

Experts say newer versions are stronger and more unpredictable. The highly addictive drug can leave users in a ‘zombie-like’ state or trigger psychotic episodes.

Spice is attractive to prisoners because it is cheap and was previously hard to detect – effective tests have only recently been developed. Until May last year there were no sanctions for prisoners possessing spice in jail, but the law now says offenders caught with the drug could face up to two further years in custody and a fine.

But prison officers warn use of the drug is at epidemic levels. In July, a two-day riot linked to a jump in supplies of the drug took place at The Mount prison in Hertfordshire.

Home Office figures show two thirds of all prison drugs seizures are for so-called ‘new psychoactive substances’, of which 99 per cent are spice.

In the first 10 months of 2015, officers at HMP Forest Bank, near Manchester, seized 4.4kg of spice – 39 times more than the 114g of cannabis and 210 times more than the 21g of heroin seized over the same period.

Dr Ryan said the wide use of spice could explain an increase in violence in prisons, as potent strains could leave up to 10 or 12 prisoners needing hospital treatment in a day. He said: ‘You have the toxic combination of wide-ranging effects and high, variable and unpredictable potency. In a closed environment like a prison it’s particularly challenging.

‘Each [hospitalised] prisoner is accompanied by a minimum of two people as an escort - that would lead to a meltdown with already over-worked staff brought to breaking point.

‘Other prisoners who have done nothing wrong will be confined to their cells due to staff shortages and will be rightly frustrated, aggrieved and angry… This level of dissatisfaction will lead to prisoners being volatile and probably is the explanation for some of the disorder we are seeing in our prisons over the past 12 month or so.

                                                                  estimated 101,200 people are living with HIV In UK  Of these, 13% are undiagnosed and do not know about their HIV infection. 594 people with HIV died. 305 were diagnosed with an AIDS defining illness, this is less than half than those diagnosed with AIDS in 2006. There were 6,095 new HIV diagnoses. Two-fifths (39%) of people diagnosed with HIV in 2015 were diagnosed late, after they should have already started treatment. 88,769 people accessed HIV care services, 41% of whom live in London. Of new HIV diagnoses in 2015, 54% were among men who have sex with men (MSM). Of those accessing HIV care, one in three (34%) are aged 50 years or older, and 5% are 65 or older. HIV testing has increased over the past 10 years. Testing rates are highest in MSM and black African people. There are now more people living with HIV in the UK than ever before. In 2015, an estimated 101,200 people in the UK were living with HIV, 13% of whom were unaware of their infection. A total of 6,095 people were newly diagnosed with HIV in 2015. The proportion of new infections from heterosexual contact that were UK-acquired has increased from 40% to 57% (2006-2015). This proportion for MSM (men who have sex with men) has seen a slight decrease over the same time period. Two-fifths (39%) of people diagnosed with HIV were diagnosed late, after they should have begun treatment. Late diagnosis is most common in certain groups, heterosexuals in particular: heterosexual men (55%) black African (53%) heterosexual women (49%) black other (49%) black Caribbean (46%) ??????? older people aged 65 and over (63%) The number of new HIV diagnoses among MSM continues to surpass the number among heterosexuals (3,320 MSM and 2,360 heterosexuals in 2015). 

• Heterosexual infections accounted for 39% of new diagnoses. Out of all newly diagnosed heterosexual men and women, 28% and 18% respectively were aged 50 or older. 
  Out of all people accessing HIV care, 34% were aged 50 or over. 
  16% of all new HIV diagnoses were among people born in Africa. This is a third of the same figure in 2006, when 41% of all new HIV diagnoses were among people born in Africa.
  The proportion of new diagnoses reported in people born in the UK has increased from 35% to 44% over the same period.

Summary: Herpes can affect inside and the outside vagina; symptoms include rash, itching, blisters, sores, ulcers & discharge. Treatments reduce recurrence of herpes vaginal symptoms.

In women, genital herpes affects the vagina and surrounding area. Vaginal herpes is an alternative term sometimes used to describe this condition in women.

Genital herpes is a sexually transmitted disease (STD) which may also be referred to as an STI (sexually transmitted infection).

There is a misconception that all STDs and STIs are transmitted solely by genital to genital contact. Genital herpes on the vagina, which is caused by the herpes simplex virus (HSV), can be transmitted through a wider range of sexual interaction including kissing and oral sex.

There are two forms of the herpes HSV virus: Type 1 and Type 2. Type 1 HSV usually affects the mouth, whilst Type 2 HSV virus affects the genital area: the vaginal area in women and the penis and testicular area in men.

The First Signs & Symptoms Of Herpes On The Vagina

Once infected, the herpes virus can remain dormant in the body for long periods of time; a woman carrying the herpes virus may have no obvious signs and symptoms.

However, the Type 2 genital herpes virus may become activated bringing a number of signs and symptoms in the vaginal area. This process is often referred to as an outbreak and can be triggered by specific events such as stress and a weakened immune system.

After an initial infection, there is usually an incubation period preceding an outbreak, lasting several days to a week, in which there are no signs or symptoms. After the incubation period, and up to a few weeks after the initial infection, the first symptoms of herpes on the vagina may be experienced.

These first symptoms are usually itching and a feeling of discomfort in the vaginal area which may be felt as a soreness and tingling sensation of the skin around the vagina. There may also be a rash; the skin around the vagina may redden in color. 

Blisters, Sores and Ulcers of the Vagina

After the first symptoms, blisters may develop around the vagina. These can be very painful and cause great discomfort. At a later stage the blisters may rupture. A blister on the vagina that has popped or burst can leak fluid around the genital area.

Ruptured vaginal blisters can lead to ulcers around the vagina. Lesions such as sores, blisters and ulcers of the vagina caused by the herpes virus usually last between one to two weeks.

Vaginal herpes can also affect the area around the genitals, including the vulva, the vaginal opening, inside the vaginal walls and the cervix.

Further signs & symptoms of herpes around the genital area include painful urination and swollen lymph nodes (found in the groin).

When the symptoms from a herpes outbreak subside, the herpes virus can remain dormant in the body. 

Some of the signs and symptoms of breast cancer include:                                                      1 a lump in the breast.           2   a change in the size or shape of the breast.      3 dimpling of the skin or thickening in the breast tissue.     4 a nipple that’s turned in (inverted).   5 a rash (like eczema) on the nippl.    6 discharge from the nipple.    7 swelling or a lump in the armpit.      8  pain or discomfort in the breast that doesn’t go away.

A lump in the breast is the most common symptom of breast cancer.

Most breast lumps are not cancer. They are usually fluid-filled lumps (cysts) or a fibroadenoma, made up of fibrous and glandular tissue.

But it is important to get anything that is unusual for you checked by your GP. The earlier breast cancer is treated, the more successful treatment is likely to be.

A former prostitute, who had a threesome with Wayne Rooney, is being questioned by police investigating a house party murder.

Jenny Thompson, 28, was spoken to by officers as part of the inquiry after a scuffle at the party in Bolton led to the death of David Molloy.

The Ex On The Beach star was a guest at the party, held by her best friend Zoe Percival, at the house which is rented from Ms Thompson's parents.  Mr Molloy was arrested on suspicion of breach of the peace, but took ill in a police car and later died in hospital.

A 34-year-old man was arrested at the house on suspicion of murder in the early hours of Sunday morning.

Last night, Ms Thompson was being comforted by her parents at their £500,000 mansion near the scene. 

There is no suggestion that she or Ms Percival are being treated as suspects. Mr Molloy was arrested on suspicion of breach of the peace, but took ill in a police car and later died in hospital.

A 34-year-old man was arrested at the house on suspicion of murder in the early hours of Sunday morning.

Last night, Ms Thompson was being comforted by her parents at their £500,000 mansion near the scene. 

There is no suggestion that she or Ms Percival are being treated as suspects.

A controlling boyfriend shouted about demons and the occult as he brutally stabbed his girlfriend to death, a court heard.

Ivan Griffin, 24, plunged a kitchen knife through Sabrina Mullings' heart and liver while her daughter Hayleigh slept in their flat in Upper Norwood, south London.

Hayleigh, 22, and her boyfriend Chaise Gore were woken up when Griffin started shouting about 'releasing demons' and 'drinking blood' at 5.30am on March 13, jurors heard.

When they rushed out of their bedroom and tried to get into the room, Griffin struggled to keep them out as Ms Mullings's blood seeped out from under the door, it is claimed.

They eventually barged through the door and found the 38-year-old victim's naked body laid out on a dressing gown on the floor of the blood-soaked scene.

The Old Bailey heard Griffin told the couple he had stabbed Ms Mullings 'because he loved her' before he fled the scene. He was arrested in Camberwell later that day and charged with Ms Mullings's murder.

Prosecutor Timothy Cray, QC, said when Hayleigh and Mr Gore were woken up, the noise 'was bad enough that they got out of bed and went across the corridor'.

'It's now certain that what they were becoming witnesses to was a scene of fear and extreme violence, and in the next 15 minutes or so what they heard, what they saw, must have seemed to them as unreal,' he said.

'Most of the noise in terms of the shouting was coming from the defendant and his words were strange, things like they had not heard from him before. Talk along the lines of releasing demons, drinking blood, strange talk of that kind.'

As Griffin struggled to stop Hayleigh and Mr Gore from getting through the door into the kitchen, Mr Cray said 'they started to see blood seep out from under the door'.

When they broke through the door and got into the front room and kitchen they were 'covered in blood'. 

Jurors heard Ms Mullings still had a faint pulse but must have been 'minutes or seconds from death'.

Mr Cray said before Griffin fled the scene he told Hayleigh 'that he had stabbed Sabrina because he loved her and he had even wanted to stab himself in order, in his words, to join their blood together'.

Griffin had wounds on his chest but they were not deep, the court was told. 

Ms Mullings was pronounced dead at the scene and a post-mortem revealed she had suffered two stab wounds inflicted with 'severe force'.

One fractured her ribcage and punctured her heart, while the other plunged through her abdomen and into her liver. After Griffin was arrested he admitted stabbing Ms Mullings - but he claims he is not guilty of murder by way of diminished responsibility relating to mental illness.

Jurors were told they will see evidence about Griffin's mental state at the time and around the time of the killing.

Two psychiatrists have assessed the defendant, but Mr Cray said 'there's no evidence that this defendant suffered from any mental illness before the attack'. Mr Gore had described the murder suspect as a 'normal sort of guy', though Hayleigh claims he was a controlling boyfriend who had shown a temper.

Mr Cray said: 'Either the defendant was suffering from some previously undiagnosed mental illness not picked up before which seems to have left him soon afterwards, or the real explanation for this killing is something much more normal, that this is a case of domestic violence.'

The prosecutor said Griffin has tried to 'disguise what he's done in the language of mental illness' because 'he can't or doesn't want to face up to it himself'.

Griffin, of Ravensdale Gardens, Upper Norwood, south London, denies murder.

He had lived in the flat next to Ms Mullings's home when they first met.

The trial continues.